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(PubMed) Bressa GM

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Caution is recommended in patients with a psychotic disorder (e.g., schizophrenia due to insufficient data

This implies sodium channel inhibition, a blockade of voltage-gated sodium channels (VGSCs) leading to a reversible block of action potential propagation [278], and reduced permeability of cell membranes, thereby blocking depolarization and preventing the conduction of the electrical impulse through which pain occurs [279]

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The 60-day recommendation builds in a safety margin accounting for tissue retention, individual metabolic variation, and the absence of human pregnancy pharmacokinetics